PROJECT SUMMARY/ABSTRACT
Mental health disparities among ethnic minorities have reached crisis proportions in the United States. Although
ethnic minorities are more likely to experience mental illnesses such as depression and associated social
determinants of health like poverty and discrimination, they are less likely to seek help from, have access to, or
receive quality mental health services. Efforts to redress such disparities and improve engagement have often
focused on adding new services or altering provider characteristics, including the implicit biases they may
unknowingly hold. However, recent scientific reviews suggest that cultural and structural barriers deeply
embedded in the underlying mental health organization itself are a significant factor in the continued persistence
of mental health disparities. While implementation science has advanced our knowledge of the relationship
between organizational factors and the uptake of evidence-based practices, there has been comparatively little
empirical research on organizational issues as they pertain to mental health disparities. This gap in research
may be due, in part, to the relative lack of operationalized constructs of disparity at the organizational level.
Based on our research, we have conceptualized a key organizational mechanism of disparities—which we
term Implicit Organizational Bias (IOB)—or, the unspoken norms, beliefs, and expectations about the
way clients should ideally behave and/or interact with the mental health system to gain optimal benefit
from available services (e.g., a client should be verbal, openly admit a problem, accept services, be proactive,
be individually-oriented). These preferred organizational norms may conflict with the norms of ethnic minority
patients, leading to a higher likelihood of incongruent, suboptimal, or compromised care. The proposed career
development award seeks to extend the substantial evidence on implicit bias beyond its focus on individuals to
the level of the organization through two phases of participatory, mixed methods research that aim: 1) To
systematically operationalize, and develop a tool to assess, Implicit Organizational Bias and its
congruence with the culture of ethnic minority communities; and 2) To examine the psychometric
properties of the IOB measure and test the pathways of association outlined in our conceptual model.
While I have extensive experience in mental health disparities research at the patient and community levels, this
K is intended to develop my skillset in: 1) implicit bias research, organizational theory, and implementation
science; 2) concept mapping and assessment development, and 3) advanced mixed methods and quantitative
research. I have established a comprehensive mentoring and training program involving national and
international leaders in disparities, implicit bias, and organizational research. My mentors, in combination with a
world-class training environment at Yale University, will guide me towards my goal of becoming an independent
investigator of multi-level influences on mental health disparities, with expertise in designing and conducting
rigorous, pragmatic research aimed at improving engagement, care, and clinical outcomes for ethnic minorities.